Benefit Specialist shift

Valeris overview

Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions spanning the entire healthcare value chain. Formed by the merger of Pharma Cord and Mercalis, Valeris revolutionizes the path from life sciences innovation to real-life impact to help ensure patients receive the care they need. Valeris works on behalf of life sciences companies to improve the patient experience so patients can access and adhere to critical medications.

With proven industry expertise, a deep commitment to patient care, the latest technology, and a talented team, Valeris provides data and strategic insights, patient support services, and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Valeris serves more than 500 life sciences customers and has provided access and affordability support to millions of patients. The company is headquartered in Morrisville, North Carolina and Jeffersonville, Indiana.

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Benefits Specialist role

When you join the team as the Benefits Specialist, you ll have the opportunity to make a difference in the lives of our patients each day as they rely on you as part of their dedicated support team to navigate the process of getting access to complex medications. You ll compassionately deliver an exceptional experience to many patients per day, remembering that every prescription or document belongs to a real person who seeks thorough and efficient management of their records.

You ll tailor your approach to their needs by communicating clearly, focusing on the accuracy of the details of their medical records and your mastery of program requirements, and ensuring their prescriptions or cases are handled timely. This role may be eligible for a hybrid schedule after 6 months (or sooner once proficiency in role is demonstrated). Review our Benefits & Perks below to learn more.

A typical day in this role includes providing in-depth knowledge of our client programs by working directly with patients, healthcare providers, and insurance companies to answer inquiries, process service requests, assess benefits coverage, and manage barriers to therapy in a compliant manner. The Benefits Specialist supports customers via telephonic and web-based channels, where applicable.

Key Responsibilities:

• Benefit Verification
  • Performing patient level benefits verifications for major medical and pharmacy benefits plans.
  • Completion of template forms that provide patient-level benefits Coverage Determination Summary.
  • Coordination of prior authorizations based on payer guidelines and in compliance with laws, regulations, or guidance.
• Patient Assistance
  • Review of patient assistance enrollment forms and supporting documentation to assess eligibility per SOPs and program guidelines.
  • Determine patient eligibility based on program criteria for qualification.
  • Communicate eligibility to the patient, healthcare provider, and/or consignment pharmacy.
  • Answer and assist inbound callers to resolution using FAQs or by warm transferring to appropriate individuals.
  • Actively listen to each customer, assess needs, and respond with patience and courtesy.
  • Identify missing or incorrect information within program service requests/applications.
  • Report Adverse Events/Product Complaint inquiries in accordance with SOP and good manufacturing practices.
  • Provide timely feedback to the company regarding service failures or customer concerns.
  • Effectively uses our internal technology platform, Pharma Cord Lynk, to complete claims processing and maintain workflows.
  • Communicate with key medical practice accounts and sales representatives regarding case status; provide consultative services to overcome obstacles to paid therapy.
  • Maintain patient-focused service while complying with company policies and procedures.
• Utilize Valeris  values as the driving force behind the team s success.
• Adhere to training deadlines for all corporate policies and procedures.
• Ensure all SOPs are followed with consistency.
• Perform additional tasks or projects as assigned.

Qualifications:

• Bachelor s degree strongly preferred or equivalent…